膈肌肌电图诊断慢性阻塞性肺疾病膈肌疲劳的临床研究  

The clinical research in diagnosing muscular fatigue of diaphragm by diaphragm electromyogram

作　　者：陈昌枝[1] 梁勇[1] 叶少武[1] 邹艺[1] 冯洁美[1] 

机构地区：[1]广西医科大学第八临床医学院 广西贵港市人民医院呼吸内科,贵港537100

出　　处：《广西医学》2006年第4期507-509,共3页Guangxi Medical Journal

基　　金：广西贵港市科技攻关课题[(2002)31号]

摘　　要：目的探讨测定膈神经传导时间(PNCT)及动作电位(AP)幅度对慢性阻塞性肺疾病(COPD)急性加重期膈肌疲劳的诊断意义。方法对42例慢性阻塞性肺疾病(COPD)急性加重期病人(COPD组)治疗前后进行膈肌肌电图检查,测定PNCT及AP,并与同期22例健康志愿者(志愿组)进行对比研究。结果志愿组PNCT左右分别为(7·016±0·516)ms、(7·089±0·531)ms;AP左右分别为(0·508±0·131)mv、(0·573±0·134)mv。COPD组治疗前PNCT左右分别为(7·982±0·563)ms、(7·912±0·692)ms;AP左右分别为(0·405±0·165)mv、(0·388±0·170)mv。COPD组治疗后PNCT左右分别为(7·764±0·509)ms、(7·729±0·520)ms;AP左右分别为(0·613±0·164)mv、(0·599±0·171)mv。志愿组与COPD组治疗前PNCT及AP的差异有高度显著性(P<0·01);志愿组与COPD组治疗后PNCT的差异有高度显著性(P<0·01),而AP的差异无显著性(P>0·05);COPD组治疗前后的PNCT差异无显著性(P>0·05),而AP的差异有高度显著性(P<0·01)。结论PNCT及AP的测定可以评价COPD急性加重期膈肌疲劳,其中AP是检测膈肌的收缩疲劳,而PNCT则是检测神经肌肉连接点的传递疲劳。Objective To probe into diagnosing muscular fatigue of diaphragm in acute exacerbation with chronic obstructive pulrmonarydisease （COPD）by mensurating the phrenic nerve conduction time（PNCT）and the swing of action potential（AP）. Methods We chose 42 inpatients in acute exacerbation with the chronic obstructive pulmonary disease（the COPD group）, who underwent a check on diaphragm dectromyogram measuring PNCT and AP before and after treatment, and process a contrastive research with 22 hygeian postuhnts（the postulant group ） in the same period.Results The PNCTs in postulant group were （7.016 ± 0.516）ms on the left side and （7.089 ± 0.531 ） ms on the right side; The APs were （ 0.508 ± 0.131 ） my on the left side and （ 0.573 ± 0.134 ） my on the right side. The PNCTs in COPD group before treatment were （7.991 ± 0.560） ms on the left side and （ 8.041 ± 0.692 ） ms on the right side; The APs were （0.405 ± 0.165）mv on the left side and （0.388 ± 0.170）my on the right side. The PNCTs in COPD group after treatment were （7.764 ± 0.509）ms on the left side and （7.729 ± 0.520）ms on the right side; The APs were （0.613 ± 0.164）mv on the left side and （0.599±0. 171）mv on the right side.The PNCTs and APs were of highly significant difference between the postulant group and the COPD group before treatment （P 〈 0. 01 ）. There were highly significant differebce between the PNCTs in the postulant group and the COPD group after treatment （P〈 0.01）, but no difference in the APs （P 〉0.05）. The PNCTs were no different before and after treatment in the COPD group （P 〉0.05）, but the APs were highly significant different （P〈 0.01 ）. Conclusion The measuration of PNCT and AP can evaluate muscular fatigue of diaphragm in acute exacerbation with COPD, the AP is for examining muscular fatigue of contraction,while the PNCT is for examining examing fatigue of neuromuscular junction.

关 键 词：膈肌肌电图 膈肌疲劳 慢性阻塞性肺疾病 

分 类 号：R563.5[医药卫生—呼吸系统]